Gary Taubes has written a sequel to his controversial book of a few years ago, Good Calories, Bad Calories. The new book is called Why We Get Fat, and What To Do About It. It presents the same material as GCBC, but without all the technical information and research citations.

Taubes' hypothesis is that the diseases of western civilization (heart disease, obesity and type II diabetes) are caused by increased intake of refined carbohydrates, not fat as has been the accepted medical wisdom for decades. I recently summarized the details of Taubes' hypothesis in the soon to be closed Good Calories, Bad Calories, by Gary Taubes thread, see Message 423.

My hope is that this thread will see significantly less discord and dissension. No one wants to be fat. Winning a discussion does no good if your position is wrong. It's in everyone's best interest to get this right, and that can only happen by cool consideration of the known facts, and only if those facts are sufficient for reaching a conclusion.

One thing we know for sure: Western civilization and other increasingly western-style countries are getting increasingly fat, and there must be an explanation. To this extent I'm on-board with Taubes: the most significant factor ain't dietary fat.

I hate preemptive conditions in opening posts, but the experience of the predecessor thread tells me that it might be prudent in this case. I'd like to propose that those who believe that Taubes' position is that all carbohydrates are equally bad or who would like to dispute other views that no one is advocating should propose their own thread to discuss them. Discussion in this thread should be limited to claims that Taubes or other thread participants actually make. I would like to avoid having this thread diverted to discussion of claims that someone would like to dispute but that no one happens to be making.

Recent discussion in the predecessor thread has been about the effect of fructose on obesity.

Taubes' hypothesis is that the diseases of western civilization (heart disease, obesity and type II diabetes) are caused by increased intake of refined carbohydrates, not fat as has been the accepted medical wisdom for decades.

What I know from personal experience is:

I eliminated sugars as much as possible from my diet, with the only source of various sugars being the natural sugars in fruits and vegetables.

I eliminated starches as much as possible from my diet, with the only source of various starches being the natural starches in vegetables. I also eliminated corn, potatoes and other vegetables that are high in natural starches.

I eliminated all breads, cereals and processed foods.

I actually increased my intake of fats (olive oil mostly, but some butter).

I increased my intake of fish, mostly salmon and the like (which are also high in fats)

I went from 215 lbs to 165 lbs and from 38"+ (almost 40") to a loose 32" waist.

I relaxed my restrictions a little to add variety to my diet, adding some simple whole grain flat breads, adding some oatmeal, and adding some beans, and I've gone back up to 175 lbs and a 34" waist.

This is anecdotal evidence, but the correlation seems pretty clear to me.

There's one big issue I'd like to enter into the conversation. If calories-in/calories-out is wrong, if it's really the food categories rather than the calories consumed that matter, then where do the extra calories go in a low carb diet?

Let's compare two diets that are equal in calories. One diet is low fat, the other is low carb. You try the low fat diet and do not lose weight. You then try the low carb diet and you do lose weight. For the low carb diet, where did the calories that were not used to maintain your weight go?

Let's look at this in just a little more detail. You try the low fat diet. The food you eat is turned into nutrients in the bloodstream. These nutrients are sufficient for maintaining your weight, so you do no lose any weight.

Now you try the low fat diet. The food you eat is also turned into nutrients in the bloodstream. These nutrients are not sufficient for maintaining your weight, so you do lose weight, but there were an equal number of calories in the food, so where did those calories go?

Many people report being more energetic and less hungry on a low carb diet, so one possibility is that the extra calories were consumed by additional activity. Whether true or not, I don't believe there's any compelling research for or against this.

Another possibility is that it is excreted. I don't know whether this is a reasonable possibility, but again, I'm unaware of any compelling research.

So that's my big question: On a low carb diet where you're still consuming the same number of calories, what happens to them?

There's one big issue I'd like to enter into the conversation. If calories-in/calories-out is wrong, if it's really the food categories rather than the calories consumed that matter, then where do the extra calories go in a low carb diet?

Well, I'm not sure. The low carb diet would not have high calorie sugars so it may be that the calorie intake by the body is slowed down, allowing them to be used to power the muscles (hence the reported higher activity levels?) rather than being dumped into fat storage because the demand for muscle use is low when the calories are all taken in with a high loading of calories.

I do have more energy, btw, but I can't be sure if this is a result of the diet or a result of being 16 months off chemo because the chemo saps your energy and depressed my level of energy below normal. I struggled with low energy levels from the chemo since the first time in 2005 (has it been that long?), and this year and the last year (since I started the diet) is the first time I feel relatively normal, energy wise. The last chemo was a new type and did not seem to affect my energy like the previous ones, so that may also be part of the equation to my energy levels this year. I certainly would not be able to do the work on the house that I have been doing with the energy levels I had 2006 to 2009.

Many people report being more energetic and less hungry on a low carb diet, so one possibility is that the extra calories were consumed by additional activity. Whether true or not, I don't believe there's any compelling research for or against this.

A little bit more energy leading to a little bit more activity can produce larger consumption of calories than just the activity alone. IIRC studies on exercise have shown that the effect of exercise on metabolism last for hours after the exercise is finished.

Another possibility is that it is excreted. I don't know whether this is a reasonable possibility, but again, I'm unaware of any compelling research.

That would be relatively easy to measure, I would think, but asking people to bring in poop samples may not appeal . . .

So that's my big question: On a low carb diet where you're still consuming the same number of calories, what happens to them?

It's possible that it goes to added muscle mass - I am stronger and have more endurance than I did a year ago. This still adds some weight, but muscle is more dense, so a little more muscle adds a little weight but not much volume.

. . . and you do lose weight.

I am more concerned with my girth than my weight, as I believe it more accurately indicates fat levels.

quote:Body Mass Index CalculatorHow Healthy Is Your Weight?Your BMI can tell you if youre carrying too much, too little or just the right amount of body fat

Note that this does not account for different body types and is really a simple estimate.

When I put in 5'-8" and 175 lbs I get a BMI of 26.7 and it says

quote:Your body mass index (BMI) is between 25.0 and 29.9, suggesting that you are overweight. Nearly two-thirds of Americans have a BMI in the overweight range.

When reviewing your BMI results, keep in mind that a BMI has its limits. For instance, BMI can overestimate body fat in athletes or others who have a muscular build. Its also wise to review results in light of your gender because the recommended amount of body fat differs for men and women.

So my physical activity and muscles may account for some of the BMI, but I have no way of knowing how much it is affected.

If I put in 165 lbs I get 25.1, just barely into the the overweight range. and looking at pictures of me at that time, I cannot see this as being overweight:

If they had an input for waist size that would be a little more accurate in this regard, being able to differentiate between athlete and couch potato by the weight distribution (I have seen one BMI calculator that had a body type selection, but nothing to input waist size). For instance, my butt size is significantly smaller to the point where pants can fall off without a belt.

The weight I've regained seems to be more centered on the belly than evenly distributed, accounting for the waist increase.

I think 165 to 170 lbs is an reasonable range for me to target, and am working on getting back down there (less couch more bike).

Percy writes:Discussion in this thread should be limited to claims that Taubes or other thread participants actually make.

In my opinion, we shouldn't even be talking about that.

As long as this thread is in The Book Nook, we should be talking about whether the book is well written, whether it is well researched, whether it is available as an e-book or in paperback, reviews of the book that appear elsewhere, etc.

Extensive discussion of the thesis should be in a different forum (in my opinion), rather than here.

Fundamentalism - the anti-American, anti-Christian branch of American Christianity

The BMI is bunk. I've tried a couple times to get my BMI below 25, and when I succeeded I was told by family, friends and coworkers that I was overdoing it, who I of course ignored. Then my doctor chimed in and I said to myself, "The doctor's not going to say it, but he knows and I now know the BMI is bunk."

Looking at your picture, you look a lot like me, and I'd say we're both pretty typical of the population. Where does the research come from that comes up with a formula that classifies thin people with mainstream body types as fat? What nonsense! I ignore the BMI now.

The body fat percentage (I'll call it BFP) is more bunk. As we age it becomes harder and harder to maintain muscle mass. If you're a male over 50 then your BFP will very likely be over 25%, which makes you obese. Ignore that, too.

The food pyramid that made carbohydrates the basis of a healthy diet for so many decades was bunk, and has now been revised. It has become my opinion that a high percentage of government and institutional diet advice is bunk. It mostly reflects institutional and political influence, not research. Taubes has convinced me that sufficient research to actually nail down what is true and not true regarding nutrition has not yet been done.

I don't think we've defined any strict criteria for what can and can't be discussed in The Book Nook. I've always thought of it as a subcategory of Coffee House. But if people feel uncomfortable having this discussion here then we can move it to a Coffee House thread.

When I created the first thread, Good Calories, Bad Calories, by Gary Taubes, I expected little discussion, and it received little attention for a while, but that changed. I didn't expect such antagonism and animosity. Even just expressing a willingness to entertain the idea that refined carbohydrates might be bad for health attracted a lot of negative attention. I can't even imagine what Taubes has had to endure.

If you'll indulge me a little, I'll relate a little of what I read yesterday.

In WWGF Taubes does something he didn't do in GCBC, which is to lean a bit on potential allies. After the mid-point of the book he begins citing Michael Pollan, author of The Omnivore's Dilemma and In Defense of Food. Pollan says much the same thing Taubes does, but evidently in way much less threatening to the diet/nutrition industrial complex. Pollan says that if we eat pretty much the same foods our great, great grandparents did that we'll do pretty well. That means we should cut out the refined carbohydrates.

Ancient pre-humans presumably lived as hunter/gatherers, and if their diets were anything like modern hunter/gatherer cultures then their diets were high in protein, high in fat, moderate in carbohydrates, and had a near zero content of refined carbohydrates. Throughout 99% of our evolutionary history refined carbohydrates were not part of our diet. It is only in the last few hundred years that refined carbohydrates have become readily available. If is refined carbohydrates that represent the significant change in our diet, and it is therefore refined carbohydrates that must be considered the most likely factor in the declining health of western civilization, particularly increasing rates of heart disease, obesity and diabetes.

The BMI is bunk. I've tried a couple times to get my BMI below 25, and when I succeeded I was told by family, friends and coworkers that I was overdoing it, ...

Yeah, I got similar comments when I was down to 165 lbs even though my BMI for that is 25.1 - still overweight.

I did get a $100 "reward card" from my health insurance company for participating in their healthy living program ...

The body fat percentage (I'll call it BFP) is more bunk. As we age it becomes harder and harder to maintain muscle mass. If you're a male over 50 then your BFP will very likely be over 25%, which makes you obese. Ignore that, too.

Yeah, I look at my waist size as a better indicator of fat/muscle ratio.

waist to height ratio? 34/68 = 0.50, 32/68= 0.47, 38/68 = 0.56

There is a body density test which involves immersion in a tank of water to get body volume, so you can't do that every day/week/month in any practical way.

The food pyramid that made carbohydrates the basis of a healthy diet for so many decades was bunk, and has now been revised. It has become my opinion that a high percentage of government and institutional diet advice is bunk. It mostly reflects institutional and political influence, not research. Taubes has convinced me that sufficient research to actually nail down what is true and not true regarding nutrition has not yet been done.

Agreed, and that was pretty much the conclusion of that video (on the previous thread?) on a scientific review of the various diets.

Without going into the reasons, my endocrinologist has placed me on a regimen of 2000 mg metformin/day (Wikipedia article on metformin). The reasons have nothing to do with diabetes, blood sugar levels, obesity or even overweight.

Weight loss is one of the side-effects of metformin, and suddenly I'm losing weight easily. I've tried gradually increasing the amount that I eat, but the weight loss continues.

If a simple drug can cause weight loss with no change in diet, with even an increase in caloric intake, then what does this say about "calories-in equals calories-out"?

Let's compare two diets that are equal in calories. One diet is low fat, the other is low carb. You try the low fat diet and do not lose weight. You then try the low carb diet and you do lose weight. For the low carb diet, where did the calories that were not used to maintain your weight go?

Let's look at this in just a little more detail. You try the low fat diet. The food you eat is turned into nutrients in the bloodstream. These nutrients are sufficient for maintaining your weight, so you do no lose any weight.

Now you try the low fat diet. The food you eat is also turned into nutrients in the bloodstream. These nutrients are not sufficient for maintaining your weight, so you do lose weight, but there were an equal number of calories in the food, so where did those calories go?

Many people report being more energetic and less hungry on a low carb diet, so one possibility is that the extra calories were consumed by additional activity. Whether true or not, I don't believe there's any compelling research for or against this.

I think that the main difference is in insulin production. Insulin encourages calories that would otherwise be burned to be stored...as fat. The low fat diet would hypothetically generate more insulin and thus more stored calories, whereas the low carb diet would encourage fat to be burned rather than stored.

If calories-in/calories-out is wrong, if it's really the food categories rather than the calories consumed that matter, then where do the extra calories go in a low carb diet?

Digestion is an active, managed process that the body participates in. It's not just osmosis. Fats, in particular, are subject to active transport across the lumen and into the bloodstream. Simple sugars, like glucose and fructose, either diffuse simply across the lumen and into the blood, or enter through passive, gradient-driven transporters.

So where did the calories go? In the case of fats, they may have been ingested but not absorbed, meaning that they left the body in the feces. Why were they not absorbed? Because the body may have responded to high body fat levels by opting not to absorb them. The body can't respond in the same way to sugars in the diet; the lumen offers relatively little control to modulate sugar absorption into the blood.

That's all my speculation; I've never seen evidence suggesting that the body actually does regulate fat absorption based on how fat you already are. But in principle, it could be; we know that fat absorption is regulated in a way that sugar absorption isn't.

So where did the calories go? In the case of fats, they may have been ingested but not absorbed, meaning that they left the body in the feces. Why were they not absorbed? Because the body may have responded to high body fat levels by opting not to absorb them.

I'd include urine along with the feces, and sweat and respiration and even spitting and nose drips as well.

"Calories-in/calories-out" says that if you want to lose weight that you have to either take in less calories, burn more calories, or both. It says diet and exercise are the only available avenues.

But this isn't true. The health/diet industry doesn't even know how many kcal/day people actually burn, or maybe it's that the estimates of how many kcal are in food is off, but something is sure way out of whack. According to the standard metrics anyone over 130 pounds consumes over 2000 kcal/day, even if they spend all their waking hours sitting at their job. So anyone consuming just 1200-1400 calories a day should be losing weight hand over fist.

Except that it doesn't seem to turn out that way. I'm sure it depends upon many factors, but the one I care about is age. As people get older, the number of kcal/day they need drops way below 2000 kcal/day, unless they're obese (it's takes a lot of calories to maintain a high weight). The health/diet industry refuses to recognize this fact. If you tell them you can't lose weight on a diet of 1200-1400 calories per day they'll say that you must be mistaken, that most likely you're seriously underestimating how much you're eating.

I eat 1200-1400 calories a day and am maintaining weight, or was until I started on the metformin. I am typical for people in my age group who are not overweight. But according to this calculator (http://www.health-calc.com/diet/energy-expenditure-advanced), which provides data consistent with many other websites, I am eating so many calories less than what I need that I should be losing weight rapidly.

My point isn't that there are still a few details about"calories-in/calories-out" that have yet to be worked out. My point is that it is wildly, crazily wrong, and that the evidence that it is wildly, crazily wrong is clearly and copiously available in the most obvious fashion, no research necessary. It doesn't match reality for most people.

Even when I was 20 it didn't add up, but in the opposite direction. I was probably 30 pounds underweight, probably ate 3000-4000 kcal/day, and could not gain an ounce. When I hit age 35 I began to gain weight, and the problem became not how to gain weight but how to keep it off, and then when that eventually failed, how to lose it.

Would that it were as simple as "calories-in/calories-out", but it's not. I think there's a growing realization that it is only a small part of the full story. Certainly the possibility you mentioned, excretions, could be a significant factor. Anything promoting the passage of food through the digestive system without being absorbed is a factor. But metabolism is also a factor, and I'm sure there must be others.

As most people age their body becomes a calorie Scrooge. The health/diet industry in conjunction with the medical industry blames the victims: As we age we tend to become more sedentary, so we must consume less calories to maintain a healthy weight. This is just more "calories-in/calories-out." They're just Johnny-one-notes and should be ignored when it comes to diet advice.

I think that the main difference is in insulin production. Insulin encourages calories that would otherwise be burned to be stored...as fat. The low fat diet would hypothetically generate more insulin and thus more stored calories, whereas the low carb diet would encourage fat to be burned rather than stored.

There's one little detail I don't agree with that I'll get to in a minute, but I agree with all the rest. The low fat diet permits the refined carbohydrates that cause insulin spikes that in turn cause the uptake of blood sugar by fat cells. The low carb diet strongly discourages refined carbohydrates. Insulin levels do not spike and there's less encouragement for fat cells.

The little detail is where you say, "Insulin encourages calories that would otherwise be burned to be stored...as fat." This is true, but insulin also encourages energy to be stored in all other types of cells as well, including muscle cells. All cells need energy.

I think you're exactly right. And the research seems to indicate that as you diet, your body becomes more efficient both at extracting calories from your food and using calories during exercise; your muscles remodel into efficient slow-twitch so that exercise has less of an effect. And that there's a form of nearly-uncontrollable "superhunger" which some people experience under caloric restriction.

I think, for many people, our only hope is bottom-up genetic re-engineering of the human metabolism. The starvation event apparently at the dawn of our species has left us utterly unequipped to deal with a world of caloric plenty. Stuff like the PEPCK supermouse holds the key, I think.

I am not sure if this is pertinent (other than maybe from a "look how little we actually know for certain" PoV):

quote:...by doing just three minutes of HIT a week for four weeks, I could expect to see significant changes in a number of important health indices.The first, and the one I was most interested in, is insulin sensitivity. Insulin removes sugar from the blood, it controls fat and when it becomes ineffective you become diabetic.